Assessing Biomedical and Psychosocial Factors in a Cross-Sectional Study of School Dropouts Among Pregnant Adolescents and Young Mothers in Quito, Ecuador.

BACKGROUND: Over nearly three decades, Ecuador experienced a significant rise in adolescent motherhood. OBJECTIVES: By focusing on social, health, and psychological aspects, the research aims to reveal the complex factors influencing the decision to discontinue education. The emphasis on providing a platform for direct expression of personal experiences not only adds qualitative depth to the study but also ensures that the voices of those involved are heard authentically. METHODS: Employing a nonexperimental, descriptive, cross-sectional approach with qualitative and quantitative methods, the research delves into the interplay of biological, psychological, and social factors. Descriptive statistics, presented through tables and graphs, were used for variable analysis, complemented by inferential statistics to validate hypotheses. Focus group sessions, processed with ATLAS.ti (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) underwent a thorough review in workshops with Servicio de Atención Integral para Adolescentes (SAIA) experts. Adolescent participants were randomly recruited through the hospital's system. RESULTS: The findings unveiled a significant dropout rate among adolescents, where pregnancy was just one factor influencing their decision. Those discontinuing education often embraced a life project centered on motherhood and domestic roles, facing domestic violence and mental health disorders. In contrast, those persisting with education were driven by professional development, facing challenges but benefiting from family support. Despite unwanted pregnancies and low contraceptive use, many found personal growth and identity affirmation in motherhood. CONCLUSIONS: Our research highlights key insights into factors like pregnancy desire, contraception, reactions, and challenges. Urgent action is needed to address systemic problems and provide holistic support, acknowledging the resilience and validity of choices made by adolescent mothers in balancing motherhood with education and career goals.

Characteristics of warfarin under-prescription in older adults with atrial fibrillation.

BACKGROUND: The prevalence of atrial fibrillation (AF) and atrial flutter (AFl) increases with age. Under-prescription of anticoagulants in older adults can lead to increased morbidity and mortality. We analyzed warfarin prescription patterns in older adults. METHODS: In this observational single-center study, we analyzed 2179 consecutive patients with admission diagnosis of AF or AFl. Patients were divided into "older" (≥ 75 years old) and "younger" (<75 years old) groups. Prescription patterns of warfarin were analyzed. Patients discharged from the hospital on a non-warfarin anticoagulation were excluded. RESULTS: Of the 1988 patients analyzed, 46.9% were ≥75 years old, of which 50.8% were prescribed warfarin. There was no association between mean CHA2DS2-VASc score and warfarin prescription on discharge (OR = 1.06 (95% CI 0.93-1.21), p = 0.388) in the older group. After adjusting for hypertension, renal function, and Black race, warfarin prescription in older adults was independently associated with lower aspirin prescription rates (OR = 0.57 (95% CI 0.43-0.75), p < 0.001), lower body mass index (OR = 1.03 (95% CI 1.01-1.06), p = 0.018), and lower hemoglobin levels (OR = 1.11 (95% CI 1.04-1.19), p = 0.002). CONCLUSIONS: In our study, older adults (≥75 years old) with AF and AFl tended to have lower rates of warfarin prescription despite higher CHA2DS2-VASc score and higher risk of thromboembolic events. Anemia, lower body weight, and aspirin use were characteristics associated with warfarin under-prescription.

Utilidad de la resonancia magnética como diagnóstico de patología del manguito rotador en pacientes con hombro doloroso / Utility of the magnetic resonance like diagnosis of pathology of the rotador sleeve in patients with painful shoulder

La resonancia magnética es un método de diagnóstico no invasivo introducido en nuestro país, desde hace cinco años por lo que hasta el momento no existen los suficientes estudios y experiencias en lo que a patología de hombro se refiere. Siendo la lesión de hombro una patología frecuente, se realizó este estudio, debido a que la resonancia magnética ha demostrado ser el método diagnóstico, no invasivo más eficaz para evaluar la patología del manguito rotador. El presente estudio de tipo descriptivo valoró cuarenta y cuatro pacientes, treinta y dos de sexo masculino y doce del sexo femenino que acudieron al Servicio de Resonancia Magnética del Hospital Carlos Andrade Marín, desde enero de 1994 hasta mayo de 1996, con diagnóstico de patología de hombro, los pacientes seleccionados fueron valorados clínicamente, además se realizó resonancia magnética, para demostrar la utilidad de ésta en la patología del manguito rotador. Se encontró que esta patología afecta principalmente al sexo masculino, la edad predominante es de 50 a 59 años, del total de pacientes analizados 72.72 por ciento fueron hombres y 27.28 por ciento fueron mujeres, la mayoría fueron sedentarios en el 75 por ciento, y activos en el 25 por ciento (p 0.05) el lado derecho fue el más afectado con el 62.50 por ciento, la etiología traumática se presentó con más frecuencia 59,38 por ciento, (pNS) seguido de enfermedad degenerativa 56,25 por ciento.